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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vaccination of children with Diphtheria, Tetanus, Poliomyelitis and pertussis vaccine (DTPoP-vaccine) containing the whole-cell pertussis component is known to be associated with manifestation of side-effects such as acute encephalopathy, convulsions and hypotensive-hyporesponsive episodes. In young and adult rats the effects of pertussis toxin and DTPoP-vaccine on haemodynamics and autonomic responsiveness are evaluated following treatment with high dose via different routes of administration (s.c., i.p. and i.v.). The effect of pertussis toxin is dose-dependent (between 1 and 20 micrograms kg-1) and largest responses are observed after i.v. administration. At 20 micrograms kg-1, i.v. pertussis toxin decreases baseline diastolic blood pressure and increases baseline heart rate by 31% and inhibits autonomic responsiveness (salbutamol-induced increase in diastolic blood pressure and arecoline-induced decrease in heart rate). In adult rats DTPoP-vaccine induces generally more prominent effects than in young rats. In adult rats DTPoP-vaccine reduces baseline diastolic blood pressure by 25% while no response is observed in young rats. In adult rats DTPoP inhibits the adrenergic response though less compared to treatment of pertussis toxin. After treatment with DTPoP-vaccine (single or twice) only minor differences are observed between young and adult rats. Present results show that adult rats are more sensitive to pertussis toxin and pertussis vaccine than young rats and that the responses depend on the route of administration.
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PMID:The effect of pertussis toxin and whole-cell pertussis vaccine on haemodynamics and autonomic responsiveness in the rat depends on route of administration and age. 956 84

Between 1 November 1993 and 31 October 1996, admissions to paediatric departments for Bordetella pertussis complications were reported to a nationwide, hospital-based active surveillance system. The case definition included pertussis complicated by pneumonia, apnoea requiring assisted ventilation, seizures, encephalopathy or a combination of these. Two hundred sixteen cases of pertussis complications were registered. 57.4% of them were in infants, 50.9% of them less than 6 months old. There were five deaths, three previously healthy children died. At the time of hospital admission, 106 cases would have been eligible for at least three doses of pertussis vaccine, only four (3.8%) had received the recommended number of immunisations. From the second quarter of 1995, the reported number of cases declined. The decrease coincides with an improvement of pertussis vaccination coverage between 1992 and 1995 due to an increased use of acellular vaccines. The reduction of complicated pertussis was observed even in age-groups too young for the recommended vaccinations. The observed decrease could be due to the increase in vaccination coverage with interruption of the chain of transmission to the younger age-groups, to a cyclic decrease in pertussis cases, or to a combination of both. Continued surveillance will provide information on the epidemiological trend of hospitalisations for pertussis complications in the first European country to have introduced vaccination with acellular vaccines on a large scale.
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PMID:Pertussis complications in Germany--3 years of hospital-based surveillance during the introduction of acellular vaccines. 971 80

A 7-year-old unimmunized girl with pertussis presented with respiratory failure and electroencephalographic evidence of an encephalopathy. The cerebrospinal fluid (CSF)/serum ratio of antibodies to pertussis toxin and filamentous hemagglutinin were 11- and ninefold higher than the CSF/serum ratio of total immunoglobulin G. The CSF/serum ratio of albumin was normal. These findings indicate production of antibodies in the central nervous system to Bordetella pertussis antigens and imply, therefore, that the pertussis encephalopathy in this girl was associated with the entry of pertussis antigens into the central nervous system.
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PMID:Pertussis encephalopathy with high cerebrospinal fluid antibody titers to pertussis toxin and filamentous hemagglutinin. 975 73

To assess the morbidity associated with the continued high levels of pertussis, we studied all children <2 years of age who were admitted to the 11 Immunization Monitoring Program--Active (IMPACT) centers, which constitute 85% of Canada's tertiary care pediatric beds. In the 7 years preceding implementation of acellular pertussis vaccine, a total of 1,082 pertussis cases were reported, of which 49.1% were culture-confirmed. The median age of the patients was 12.4 weeks; 78.9% of cases were in children <6 months of age. Complications of pertussis were common: pneumonia was reported in 9.4% of cases, new seizures in 2.3%, and encephalopathy in 0.5%. There were 10 deaths (0.9%), all in children < or =6 months of age. Duration of hospitalization was longer (9.3 days vs. 4.9 days; P = .001) and intensive care was required more frequently (19.2% vs. 4.9%; P = .001) in infants under <6 months of age than in those > or =6 months. Pertussis continues to cause significant morbidity and occasional mortality in Canada, particularly in young infants.
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PMID:Epidemiological features of pertussis in hospitalized patients in Canada, 1991-1997: report of the Immunization Monitoring Program--Active (IMPACT). 1045 Nov 59

Parenteral injection of endotoxin has been used as a model to examine the role of pro-inflammatory cytokines in the centrally controlled responses to Gram-negative bacterial infection. However, the events that occur following mucosal exposure to live bacteria have received little attention. In this study, we have used a murine model to demonstrate that respiratory infection with Bordetella pertussis, which is associated with a number of systemic complications including fever, seizure and encephalopathy in children, resulted in persistent expression of mRNA transcripts for IL-1beta and TNFalpha and transient expression of IL-6 in the hippocampus and hypothalamus. These changes correlated with elevated levels of cytokine protein in the same brain areas. The results demonstrate that infection at a mucosal surface can result in the induction of pro-inflammatory cytokine production in the brain and suggest that these locally synthesized mediators may contribute to the centrally controlled clinical manifestations of B. pertussis infection.
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PMID:Induction of inflammatory cytokines in the brain following respiratory infection with Bordetella pertussis. 1063 86

Pertussis infection is associated with significant morbidity in younger children (<4 years), which can include pneumonia, seizures and encephalopathy. Around one in 250 cases of pertussis in infants under the age of 6 months lead to death or severe brain damage. In the United Kingdom the control of pertussis infection has been based on a three-dose schedule of combined diphtheria, tetanus, whole-cell pertussis vaccine (DTPw) during the first 4 months of life. Coverage rates for primary vaccination are currently at high levels of over 90 per cent and infection rates are relatively low (approximately 1.2 per 100,000). However, there are concerns over the potential under-reporting of pertussis and clear shifts in the age pattern of notified cases are evident, with surveillance data suggesting a possible upward trend in the absolute numbers of infections in those at most risk (i.e. infants <3 months old). The addition of childhood booster dose(s) of pertussis vaccine to the standard schedule has potential clinical benefits and may be cost-effective. Selective adult booster immunization may also have a role to play in controlling the circulation of pertussis.
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PMID:Do we need to boost pertussis immunization within the existing UK vaccination schedule? 1107 9

A study recently published in the Lancet compared the incidence of pertussis between 1940 and 1996 in countries where vaccination with DTP vaccine reached a steady 90-100% of the population for many years against those in which coverage fell sharply following propaganda-driven vaccine scares. It was found that the incidence of a disease can be up to 100 times higher in a country where vaccination against the disease is disrupted by anti-vaccine movements than in countries where coverage of the population with the vaccine always remains high. It can take 10-20 years to reverse the potentially major damage caused by anti-vaccination movements. There may have been hundreds of thousands of cases of pertussis among children deprived of vaccine, while tens of thousands of cases of disease-related clinical complications such as pneumonia, encephalopathy, and seizures may have resulted.
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PMID:Immunization news. 1217 11

A medical officer for the Expanded Program on Immunization (EPI) of the World Health Organization (WHO) calls for staff at all health facilities to screen and, if appropriate, immunize every infant, child, and woman of reproductive age attending health facilities. Routine immunization services tend to miss many women and children who should be immunized. Three important components comprise the health team approach needed to avoid missed opportunities: awareness to screen, a well-organized referral system within each health facility, and regular availability of vaccines. In the health facility, the nonimmunized child is at risk of contracting measles, so all such children should be immunized before they leave the health facility. The WHO/EPI medical officer presents five ways to avoid missed opportunities: screen and immunize at every opportunity, administer all required vaccines, stress real and avoid false contraindications, train staff, and open new vials of vaccine when needed. Contraindications to immunization include severe adverse reactions after a dose of vaccine (collapse or shock, convulsions without fever, anaphylaxis, or encephalitis/encephalopathy), neurological disease (for vaccines containing whole cell pertussis), immune deficiency diseases or immunosuppression due to drugs (generally for live vaccines), and symptomatic HIV infections (for BCG or yellow fever vaccines). The following conditions do not preclude immunization: minor illnesses (e.g., upper respiratory infections); allergy, asthma, hay fever, or "snuffles"; prematurity, small-for-date infants; malnutrition; breast feeding; family history of convulsions; treatment with antibiotics, low-dose corticosteroids, or locally acting steroids; eczema or localized skin infection; chronic diseases of the heart, lung, kidney, or liver; stable neurological conditions (e.g., Down syndrome), and history of jaundice after birth. WHO/EPI has an exit survey for use at district-level clinics or hospitals available so program managers can learn if they are missing chances to immunize children.
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PMID:Opportunities to immunise. 1229 31

The alpha chemokine receptor CXCR4 is used as the major coreceptor for the cell entry of T-cell-tropic human immunodeficiency virus-1 (HIV-1) isolates. Activation of this coreceptor by its natural ligand SDF1alpha is associated with an intracellular Ca(2+) increase. Because the HIV-1 glycoprotein 120 (gp120) is shedded from the surface of HIV-1-infected cells and is regarded as an injurious molecule in the pathogenesis of HIV-1-associated encephalopathy (HIVE), we investigated the effects of gp120 on the intracellular Ca(2+) regulation of astrocytes and neurons. After 5 days in vitro (DIV), SDF1alpha (50 nM) elicited a pertussis toxin-sensitive intracellular Ca(2+) increase due to Ca(2+) release from internal stores that was reduced by a blocking monoclonal antibody against the CXCR4 receptor in astrocytes and neurons. Parallel with the development of the SDF1alpha response, cells became sensitive to direct application of gp120 (1.25 microg/ml), which, similarly to SDF1alpha, elicited a transient intracellular Ca(2+) increase. However, short-term incubation with gp120 for 60 to 120 min induced a reduction of glutamate- or ATP-evoked intracellular Ca(2+) responses only in astrocytes and not in neurons, although functional CXCR4 receptors were expressed in both cell types. Therefore, our data strongly suggest that the CXCR4 receptor-mediated intracellular signaling pathway of gp120 differs in astrocytes and neurons.
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PMID:Functional CXCR4 receptor development parallels sensitivity to HIV-1 gp120 in cultured rat astroglial cells but not in cultured rat cortical neurons. 1240 67

In this report we describe pertussis toxin-induced reversible encephalopathy dependent on monocyte chemoattractant protein-1 (MCP-1) overexpression (PREMO), a novel animal model that exhibits features of human encephalopathic complications of inflammatory disorders such as viral meningoencephalitis and Lyme neuroborreliosis as well as the mild toxic encephalopathy that commonly precedes relapses of multiple sclerosis (MS). Overexpression of the mouse MCP-1 gene product (classically termed JE) in astrocytes, the major physiological CNS cellular source of MCP-1, failed to induce neurological impairment. Unexpectedly, transgenic (tg) mice overexpressing MCP-1 at a high level (MCP-1(hi)) manifested transient, severe encephalopathy with high mortality after injections of pertussis toxin (PTx) plus complete Freund's adjuvant (CFA). Surviving mice showed markedly improved function and did not relapse during a prolonged period of observation. Tg mice that expressed lower levels of MCP-1 were affected minimally after CFA/PTx injections, and tg expression of other chemokines failed to elicit this disorder. The disorder was significantly milder in mice lacking T-cells, which therefore play a deleterious role in this encephalopathic process. Disruption of CC chemokine receptor 2 (CCR2) abolished both CNS inflammation and encephalopathy, identifying CCR2 as a relevant receptor for this disorder. Proinflammatory and type 1 cytokines including TNF-alpha, IL-1beta, IFN-gamma, IL-2, RANTES, and IP-10 were elevated in CNS tissues from mice with PREMO. These studies characterize a novel model of reversible inflammatory encephalopathy that is dependent on both genetic and environmental factors.
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PMID:Pertussis toxin-induced reversible encephalopathy dependent on monocyte chemoattractant protein-1 overexpression in mice. 1248 56


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